https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=9571

Elvitegravir / Cobicistat

Rifampicin

Contraindicated.

No pharmaceutical opinion available for this interaction.

Mechanism

Rifampicin can induce the metabolism (CYP 3A4 and 2D6) and UGT 1A3 and decrease the plasma concentration of elvitegravir and cobicistat .

Elvitegravir / Cobicistat

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Risk of a possible development of resistance to antiretroviral class.

Recommendations

–

Alternative solution(s)

In patients without resistance to integrase inhibitors, dolutegravir 50 mg BID or raltegravir 800 mg BID : see dolutegravir + rifampicin or raltegravir + rifampicin.

Rifampicin

Pharmacodynamic effects

–

Recommendations

Contraindicated. Use alternative.

Alternative solution(s)

Antibiotic not interacting with elvitegravir/cobicistat or rifabutin 150 mg 3 times a week if the use of a rifamycin is inevitable. See elvitegravir/cobicistat + rifabutin.

Monitor

Hepatotoxicity: elevation of hepatic transaminases by 3 to 5 fold, fatigue, unusual weakness, nausea, vomiting, anorexia, abdominal pains, pale stools, dark urine, jaundice.

Tests

–

Pharmacokinetic parameters

–

Comment

–

Comment
Reference
  • 2570
    Elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), Gilead, Ontario, Canada, 17 septembre 2018.
  • 3116
    Center for Disease Control and prevention. Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis. Disponible: http://www.cdc.gov/tb/publications/guidelines/tb_hiv_drugs/recommendations03.htm Publié le 22 sept 2014. Consulté le 11 janvier 2018.
  • 3281
    Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (Genvoya), Gilead, Ontario, Canada, 6 août 2021.